Carmicheal LLC

NPI #1861777690 in Belleville, Illinois

Provider Information

NPI Number: 1861777690
Entity Type: Organization
Organization Name: Carmicheal LLC
Primary Specialty: General Practice
Enumeration Date: Oct 12, 2011
Last Updated: Jul 18, 2012

Practice Location

Address: 8601 WEST MAIN ST.
Address 2: STE. 101
City: Belleville
State: Illinois
ZIP Code: 62223
Phone: (618) 398-6266

Authorized Official

Name: DR. CRYSTAL CARMICHEAL, MD
Title: PRESIDENT
Phone: (618) 398-6266

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
General Practice	208D00000X	Primary

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